This proposal is in response to the NHLBI's call for "Novel Methods of Monitoring Health Disparities." The University of Wisconsin (UW) School of Medicine and Public Health (SMPH) and its partners propose to build an innovative research network to monitor the effects of economic and policy changes on cardiovascular and respiratory health in communities. The main focus will be to identify the determinants of the state's significant health inequities according to place of residence, race/ethnicity, gender, and socioeconomic status. We will create a model information network called the Wisconsin Health Equity Network (WHEN) by linking unique existing resources that assess the health of Wisconsin individuals and communities at multiple levels. These resources include: (1) the Survey of the Health of Wisconsin (SHOW): an annual survey of representative samples of state communities and their adult residents including data on demographics, employment, medical history and health behaviors, access to health care, quality of life, as well as an individuals'physical exam and blood/urine samples;(2) the Wisconsin County Health Rankings: an annual summary of the health status of the population in all Wisconsin counties;(3) the Wisconsin Collaborative for Health Care Quality: a consortium of health care provider organizations (physician groups, health plans, hospital) sharing health care quality data;and (4) What Works-Policies and Programs to Improve Wisconsin's Health: a compendium of programs and policies that might influence health and reduce health disparities. Funding for this program will support the expansion of the SHOW by increasing its sample size and recruitment incentives, and by adding a new rural-based field station in addition to the existing urban-based SHOW facilities in Milwaukee and Madison. It will also support the addition of a mail survey assessing health status of a representative sample of Wisconsin residents, as well as interviews with public health and health care leaders in the communities sampled each year. Methods to link the above sources of information will be developed;the use of this network of information on health, health care quality, and public health resources to assess how concurrent shifts in the global and local economy affect health disparities will be tested. Building on existing community-academic partnerships within the UW Institute for Clinical and Translational Research and the UW Population Health Institute, WHEN will engage community organizations and health professionals and will use these resources to disseminate results and identify strategies for intervention. WHEN have national implications. It provides a finer resolution lacking in national surveys to adequately assess health disparities at the community level where multiple determinants operate. The proposed funding will leverage resources developed through a strong UW-SMPH commitment to integrate Medicine and Public Health and improve population health. Consistent with this mission, a sustainable WHEN will serve as a unique-in-the-nation model for addressing population health and health disparities. PUBLIC HEALTH RELEVANCE: The Wisconsin Health Equity Network (WHEN) will expand the Survey of the Health of Wisconsin, an infrastructure for population health monitoring, and combine individual level information with data from three other organizations that monitor the quality of medical care, health care costs and public health policies in the state of Wisconsin. The Network will be a one-of-a kind model for identifying the cause of population differences in heart and lung disease, two of the most significant causes of death and disability in the United States. WHEN is built upon a population health foundation and contributes to NIH goals by enhancing public health and creating opportunities for identification of programs to reduce health inequalities.